Is your insurance company treating you unfairly?

Your insurance company must treat you fairly pursuant to its obligation of good faith and fairness. In practical terms, it means that those who sustain personal injuries in an accident and apply for accident benefits from their automobile insurer must be treated in a manner that would help them in their recovery and rehabilitation.

The law prohibits your insurer from withholding or delaying payment of benefits unreasonably.

In a recently released decision A.J. v. Security National Insurance Co., 2021 ONLAT the Ontario Licence Appeal Tribunal (LAT) ordered an award for $8,598.95 (equal to 30%) plus interest on top of payment of benefits owed against the insurer for not treating the insured individual in a fair and prompt manner.

The applicant was injured in a motor vehicle accident and sought accident benefits from the insurance company under the Ontario’s Statutory Accident Benefits Schedule. She appealed to the Tribunal for an award citing an unreasonable delay by the insurer in providing her the accident benefits.

The adjudicator held that the insurer’s failure to acknowledge the receipt of the OCF-3: Disability Certificate sent by the insured and then the lack of response to her follow-up communications for status update for nearly a year was unreasonable conduct that warranted an award against the insurer.

Moreover, it was stated that in addition to the established factors in case law for determining appropriate quantum of the award, “other criteria which may be considered is whether the insurance company acted professionally in its handling of an insured’s claim or whether there has been a pattern of unreasonable conduct in the respondent’s handling of the applicant’s claim in relation to other benefits”.

As mentioned in our previous article Court punishes insurance company for bad faith conduct requiring payment of $200,000 for punitive damages, the Ontario Court of Appeal had held in Fernandes v. Penncorp Life Insurance Company, 2014 ONCA 615 that punitive damages can be awarded where the insurance company has not dealt with the insured in a fair and balanced manner as required under an established duty of good faith in Canadian law. Ontario’s Appeal Court has also stated in Usanovic v. Penncorp Life Insurance Company (La Capitale Financial Security Insurance Company), 2017 ONCA 395 that “the insurer must give as much consideration to the welfare of the insured as to its own interests”.

If you have sustained personal injury in an accident and feel that you are not being treated fairly by your insurance company, the lawyers at Virk Personal Injury Law are available to explain your rights and different options to make things right.

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